Therapeutic hip and ankle arthroscopies leading to Joint Preservation : An

Innovative approach

Dr Abdul D Khan
MRCS(Edin, UK), MRCS(Glasg, UK), FRCS(Tr&Orth)UK, CCT(Tr&Orth)UK
Consultant Orthopaedic Surgeon

A 29 year old female presented with severe right hip pain since 6 months after a fall. She had
radiographs and MRI scan which showed articular depression of the femoral head secondary to
femoral head fracture along with loose articular fragment in the hip joint. She was treated with
rest, analgesics & physiotherapy with little relief. Normally as per the current practice in our
region, no surgical treatment is adviced till the patient develops severe symptomatic arthritis
eventually needing total hip replacement. Doing total hip replacement at such an early age will lead
loosening and need for few more revision surgeries in her life time.

After informed consent, Dr Khan performed therapeutic hip arthroscopic debridement,

synovectomy, abrasion chondroplasty and removal of the loose articular fragment. The patient
mobilised well and was discharged from the hospital within 24 hours. By doing this therapeutic hip
arthroscopy, we had prolonged the life of her native hip.

A 49 year old female presented with right ankle pain since 2 years. She had radiographs and MRI
scan which showed moderate arthritis in her ankle. She was treated with analgesics, brace,
physiotherapy and rest but no relief. Normally as per current practice in our region, the patient is
treated conservatively and only when the symptoms become very severe, an open ankle fusion is
adviced. This procedure has complications including infection, neuro vascular injuries and will alter
the biomechanical performance of the foot leading to arthritis in the adjoining joints.

After informed consent, Dr Khan performed therapeutic ankle arthroscopic debridement,

synovectomy, abrasion chondroplasty, excision of distal tibial and talar osteophytes. He also took
bone marrow aspirate from the iliac crest and did autologous stem cell implantation in the ankle
joint. The patient mobilised well and was discharged from the hospital within 24 hours. By doing this
ankle arthroscopy, we had prolonged the life of her native ankle.

These are first of such joint preserving therapeutic arthroscopic procedures ( hip and ankle ) done in
our AP state and adjoining regions.